Older Children Can Benefit From Treatment For Childhood’s Most Common Eye Disorder

Pediatric Eye Disease Investigator Group (Scheiman MM, Hertle RW, Beck RW, Edwards AR, principal authors). Randomized Trial of Treatment of Amblyopia in Children Aged 7 to 17 Years. Archives of Ophthalmology 2005;123:437-447.


There were 507 children from 49 centers participating in this study. The treatment centers included the Wilmer Eye Institute of Johns Hopkins University in Baltimore, Maryland as well as the Mayo Clinic in Rochester.

This statement was the headline of a press release from the National Eye Institute (NEI) involving a study that was published in the April 2005 issue of Archives of Ophthalmology. NEI is part of the National Institutes of Health (NIH) and is the Federal government’s lead agency for vision research that leads to sight-saving treatments. The NIH is an agency of the U.S. Department of Health and Human Services.


Developmental optometrists have been successfully treating older children, and even adults, with amblyopia for many years. So the results of this nationwide clinical trial show that many children age seven through 17 with amblyopia (lazy eye) may benefit from treatments that are more commonly used on younger children comes as no surprise. But to the medical community at large, this was big news, and appeared on many websites worldwide.


Treatment improved the vision of many of the 507 older children with amblyopia studied at 49 eye centers. Previously, eye care professionals often thought that treating amblyopia in older children would be of little benefit. “Doctors can now feel confident that traditional treatments for amblyopia will work for many older children,” said Paul A. Sieving, M.D., Ph.D., director of the NEI. “This is important because it is estimated that as many as three percent of children in the United States have some degree of vision impairment due to amblyopia. Many of these children do not receive treatment while they are young,” he said.


Amblyopia is a leading cause of vision impairment in children and usually begins in infancy or childhood. It is a condition resulting in poor vision in an otherwise healthy eye due to unequal or abnormal visual input while the brain is developing in infancy and childhood. The most common causes of amblyopia are crossed or wandering eye (strabismus) or significant differences in power between the eyes related to differences in astigmatism, farsightedness, or nearsightedness.


Children in the study were divided randomly into two groups. One group was fitted with new prescription glasses only. The other group was fitted with glasses as well as patching or eye drops, along with specific vision therapy activities. The study investigators defined successful vision improvement as the ability to read (with the eye with amblyopia) at least two more lines on a standard eye chart. The study investigators found that 53 percent of children age seven through 12 years who received both glasses and treatment with patches and near activity met this standard, while only 25 percent of those children in this age group who received glasses alone met the standard. In addition, among children age 13 through 17 years who had not been previously treated for amblyopia, 47 percent of those who were treated with glasses, patching and near activities improved two lines or more compared with only 20 percent of those treated with glasses alone.


Commented co-chairman Mitchell M. Scheiman, O.D., Pennsylvania College of Optometry, “This study shows that age alone should not be used as a factor to decide whether or not to treat a child for amblyopia. The opportunity to treat amblyopia does not end with the pre-school years.”